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Just Wondering

Back during the Bush Administration, I created a couple of controversial posts pointing out that Bush had achieved several longstanding liberal goals, including a vast expansion of Medicare, and greater federal aid to, and control of, local education. However, he got very little credit from the liberal side for these achievements.

On the Medicare front, commenters, other bloggers, and my email correspondents insisted that the Medicare expansion was simply a “payoff” or “giveaway” to the drug industry because it expanded the industry’s customer base without creating price controls, or even allowing the federal government to negotiate drug prices directly. My interlocutors held this position with great vehemence. (Indeed, this was a major Democratic talking point and a common enough criticism to inspire an academic paper, “Was [Medicare] Part D a giveaway to the pharmaceutical industry?”)

With a sweeping overhaul of the nation’s health care system, Congress would be giving the health care industry as many as 32 million additional paying customers in the next few years.

That would mean millions more Americans buying private health insurance and better able to pay for their hospital stays, doctors’ visits, prescription drugs and medical devices.

And some analysts said as the vote neared that the final legislation was shaping up as much kinder to the industry than many initially feared. Hospitals and drug makers, which supported the final legislation, would be clear beneficiaries, analysts say, even if the outlook for insurers was less certain….

Drug makers, meanwhile, may have the most clear reason to celebrate the legislation. Pharmaceutical companies are going to be asked to contribute $85 billion toward the cost of the bill in the form of industry fees and lower prices paid under government programs over 10 years. But they can look forward to tens of billions of dollars in additional revenue as more people with insurance visit doctors and fill prescriptions.

The legislation will also eventually close the gap in Medicare drug coverage, known as the doughnut hole, in which elderly patients must pay for prescription drugs rather than having them covered by the government. Many chose to stop taking their medicine or switched to lower-price generics.

And significantly, the legislation allowed the drug industry to “avoid any of the issues that were particularly of concern — price control or more regulation by the federal government,” said Barbara Ryan, an analyst with Deutsche Bank.

I’m looking forward to seeing all of Bush’s critics on his Medicare “giveaway” at the next tea party rally!

But seriously, I’m really wondering, if you were among my liberal interlocutors who adopted the line that Medicare Part D was a malevolent “giveaway” to the drug companies, how are you feeling about Obamacare?

UPDATE: Speaking of which, if the problem the Democrats in Congress identified with Medicare Part D was its failure to coerce a reduction in drug prices, why haven’t the Democrats used their huge Obama era majorities to reverse that?